2022-07-05 Ex 06``�y.Of•OKEF�h
- T 1111ty of Okeechobee
o -o
Memo
• � 91
Date: for July 5th meeting
TO: Mayor and City Council
FR: Gary Ritter, City Administrator and India Riedel, Finance Director
RE: PRM Group Health Insurance
The City's current premium structure for plan 0727:
Employee Only $ 937.25 Empl & Spouse $2,339.88
Empl & child(ren) $1,871.02 Empl Family $2,984.56
Exhibit 6
7/5/2022
The City's' claim experience based on the rates from the last seven month period beginning
October 1, 2022 continues to be stable. The medical claims to date have not included any
large claims (i.e. $150,000 or more) which can severely impact a municipality our size.
With the application of the City's claims experience rating, the renewal premium for FY 2021-
2022 is at 4% increase, which is the same for PRM Group of 4%. The fiscal impact based on
the number of employees equates to a $25,865 for the renewal.
Additional Offerings:
Health Savings Account plan options 05180 and 05181 offers added benefits to the City as
well as the employee. These options could potentially decrease the City's future claims as
the employee would be responsible for the first $2,500 in medical cost, therefore reducing
payout of claims. The HSA account is partially funded from the difference in the premiums
that the City would be paying from the 0727 plan. The HSA dollars if not used roll over to the
next year, and the next. The other major benefit is the employee is more in charge of his/her
health care and cost. There is an added administrative cost for the HSA per month per
employee who select the plan ($2.70 a month).
Public Risk Management (PRM) has been looking at options for retirees who are Medicare
Eligible. Florida Blue is offering 2 Medicare supplements that we can offer these individuals
at a substantial savings. These are options and are not mandatory.
BlueMedicare Elite PPO $339.43
BlueMedicare Platinum PPO $322.93
We are continuing to take a long term approach regarding the health of its employees by
continuing the current benefits as well as adding plan options in addition to the Clinic.
1 I Page
%-,ity of Okeechobee
Memo
Current PPO plan, 0727
City Cost
Deduction
Premium
Per Employee
per
Employee
per Month
Pay Check
Employee Only
$974.74
$974.74
$0.00
Add'l for Spouse
$1,458.73
$150.00
$604.03
Add'I for Child (ern)
$971.12
$150.00
$378.98
Add'I for Family
$2,129.20
$150.00
$913.48
H SA 5810/5181
City Cost
Deduction
Premium
Per Employee
per
Employee
per Month
Pay Check
Employee Only
$843.33
$974.74
$0.00
Add'I for Spouse
$1,262.18
$150.00
$513.32
Add'I for Child ern
$840.19
$150.00
$318.55
Add'I for Family
$1,842.30
$150.00
$781.07
Medicare Plans
Elite
Platinum
Eligible Retirees
$339.43
$322.93
2 1 P a g e
PUBLIC RISK MANAGEMENT
BLUEOPTION MEDICAL COMPARISON
EFFECTIVE OCTOBER 1, 2022
Plan Year Deductibles
Individual/Family
In -Network
Out -of -Network
Coinsurance (When Applicable)
In -Network
Out -of -Network
Out of Pocket Maximum
In -Network
Out -of -Network
Professional Provider Services
PCP Office Visits
Specialist Office Visit
Out -of -Network
Teladoc Visits
Out -of -Network
Preventative Care Visits
Out -of -Network
Hospital Services
Inpatient Hospitalization
Out -of -Network
Outpatient Hospitalization
Out -of -Network
Urgent Care Center
Out -of -Network
Emergency Room
Out -of -Network
Lab (Blood
In -Network
, MRA, CT and PET Facility
In -Network
Out -of -Network
Prescription Drugs
Tier 1
Tier 2
Tier 3
Mail Order Pharmacy
Out -of -Network
$500 / $1,500 $2500/$5000
Combined with In- $5000/$10,000
Network
20% I 0%
40% 20% of Allowed Amount
$1,500 / $4,500 I $2500/$5000
Combined with In- $10,000/$20,000
Network
$15
Deductible
$15
Deductible
40% Ater Deductible
20% After Deductible
Visit 1-4 $0, 5+ $10
Deductible
N/A
N/A
$0
$0
40%
20% after deductible
20% After Deductible
Deductible
$300 PAD, 40% after
Not Covered
20% After Deductible
Deductible
40% Ater Deductible
Not Covered
$15
Deductible
$15
Deductible
20% after deductible
Deductible
20% after deductible
Deuctible
20% I Deductible
40% 20% After Deductible
$ 15.00
40% After deductible
$5
$35
$35
$10/$70/$70
50% of allowance
Deductible
After Deductible
Deductible
Deductible
Deductible
50% After Deductible
2022-2023 Health Plans Comparison